Current ECG Podcast

This episode features Matt Pigott from Medic Minute with Matt to share his insights about 12 Lead ECG and Coronary Anatomy. Also In This Episode Before you get started Looking at your 12 Lead How does this reflect Coronary Anatomy? Changes in morphology Perfusion issue Blood flow through the heart Electrical issue Electrolyte issue Cardiac action potential PQRST segment "STEMI mimics" RCA Occlusions 55 y/o patient case example(s) Proximal or Distal? Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding. Subscribe now at CurrentECG.com And Stay Current

On this episode Dave is joined by Dr. Jerry W. Jones, MD FACEP FAAEM, to discuss why ST elevation is not always an infarction. Dr. Jones will highlight why we need to think about morphology and shape when interpreting ECGs and why reciprocal changes are just as important as the primary changes and more! Dr. Jones is the CEO and Founder of Medicus of Houston. Medicus of Houston is a continuing medical education company that specializes in advanced ECG interpretation and instruction. He is a Board-certified emergency physician, author, speaker, instructor and and internationally-recognized expert in electrocardiography. Dr. Jones is a diplomate of the American Board of Emergency Medicine who has practiced internal medicine and emergency medicine for over 40 years. Also In This Episode How to diagnose real infarctions How ischemia damages the cell Cells creating electrical current How electrical current creates is responsible for ST depression and elevation Systolic and Diastolic currents of injury How not to confuse subendocardial ischemia with reciprocal change Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding. Subscribe now at CurrentECG.com And Stay Current!

In this episode, Dave shares about moving away from the concept of ST-Elevation Myocardial Infarction (STEMI) and focusing on Occlusion Myocardial Infarction (OMI). Also In This Episode: OMI vs. STEMI Patient Case: 70 YO Male De Winter's T Waves ECG Tracing example ECG Diagnostic criteria ECG Tracing examples Review - Patient Case: 70 YO Male Activate Cath Lab Take home points Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding. Subscribe now at CurrentECG.com And Stay Current! .

On this episode Dave is joined by Dr. Jerry W. Jones, MD FACEP FAAEM. Dr. Jones is the CEO and Founder of Medicus of Houston. Medicus of Houston is a continuing medical education company that specializes in advanced ECG interpretation and instruction. He is a Board-certified emergency physician, author, speaker, instructor and and internationally-recognized expert in electrocardiography. Dr. Jones is a diplomate of the American Board of Emergency Medicine who has practiced internal medicine and emergency medicine for over 40 years. Also In This Episode What is a Reciprocal Change? The rules of Reciprocal Change Only in the same plane as ST elevation The leads manifesting reciprocal change should be as close to 180 degrees away from the leads with ST elevation as possible. ST Elevation / Reciprocal Pairs Inferior Epicardial Ischemia with Reciprocal Change Basolateral Epicardial Ischemia with Reciprocal Change Posterior / Lateral Epicardial Ischemia Epicardial Ischemia with Reciprocal Change ECG Tracing example An impulse travelling perpendicular to a lead axis cannot be seen in that lead. ECG Tracing example Ventricular Aneurysm The Problem with Anterior ST Elevation LAD Occlusion and Reciprocal Changes ECG Tracing examples Acute Pericarditis Danger is hiding in Reciprocal changes ECG Tracing example ECG Tracing example Subendocardial Ischemia or Reciprocal Change? ECG Tracing examples of Reciprocal changes ECG Tracing examples of Subendocardial Ischemia Six points to remember Dave's take-home points Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding. Subscribe now at CurrentECG.com And Stay Current!

In this episode, Dave shares the importance of practicing quality CPR with the goal of being the 'ultimate compressor'. Also In This Episode: Patient case which deteriorates to cardiac arrest- AHA/ILCOR ECC guidelines to begin immediate chest compressions and application of the cardiac monitor with an attempt at defibrillation. Work as a team on the choreography of resuscitation. Ensuring no one provider has a cognitive overload and is able to focus on a specific assigned task. Ensure the provider who is performing the skill of chest compressions is able to focus on the appropriate rate, minimizing pauses, and allowing for complete chest recoil. CPP - Coronary Perfusion Pressure is the key to providing the cardiomyocytes with the sugar, water, oxygen they need to survive by perfusing the coronary ostia and building CPP. Post ROSC care should include maintaining a systolic blood pressure of at least 90mmhg, 02 sats between 94-99%, patient normothermia, 12 lead ECG interpretation and finally working with other health care providers on a coordinated transfer of care. Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding. Subscribe now at CurrentECG.com And Stay Current!

In this episode, Dave highlights one some consider to be the ultimate imposter- Hyperkalemia. Hyperkalemia is a life threatening electrolyte abnormality that can be easily missed in the emergency setting, and it is vitally important that we can recognize this by interpreting our patients ECG. Also In This Episode ECG example - Diagnosis Depolarization - what's happening at the cellular level. You don't want to miss it. What is Hyperkalemia? ECG example Hyperkalemia is a primary cellular problem which is why is produces global changes on the ECG. Is that Asystole? Nope it's sinus rhythm in Hyperkalemia "mic drop"! Calcium backdoor solution to temporary stabilization of the cardiomyocytes. Buying your patient time to definitive care. Potassium levels produce characteristic ECG changes but it's not sharp and point T waves... Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding. Subscribe now at CurrentECG.com And Stay Current!

In this episode, Dave presents on some of the ECG interpretation basics and how to avoid being making incorrect interpretation at 3am when you are hungry and tired. Also In This Episode Interpretation basics Atrial Fibrillation ECG Tracing Example 1 - 3 Turn the volume up on your monitor ECG Tracing Example 4 - 9 Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding. Subscribe now at CurrentECG.com And Stay Current!

In this episode, Dave discusses how it is important as practitioners to understand how blood PH can effect how we manage and treat our patients. Also In This Episode How do we provide oxygen and what is it doing? Oxygen disassociation curve Acidotic environment Alkalotic environment The cells need sugar, water, oxygen to survive! Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding. Subscribe now at CurrentECG.com And Stay Current!

In this episode, Dave is joined by Tarlan Hedayati, MD, to discuss Bradycardias and Blocks. Dr.Hedayati is a practicing Emergency Physican in Cook County, Chicago. She is also the Associate Professor and Chair of Education for the Emergency Medicine Department. Also In This Episode Defining Bradycardia Stable vs. unstable Sinus vs. not sinus Narrow vs. wide AV Blocks ECG Tracing example 1 1st Degree AV Block 2nd Degree AV Block ECG Tracing example 2 ECG Tracing example 3 3rd Degree Heart Block What is causing this Bradycardia? ECG Tracing example 4 Bradycardia in ACS Clinical context ECG Tracing example 5 The Brady Bunch Beta Blockers, CCB, Clonidine, Digoxin ECG Tracing example 6 Hyperkalemia ECG Tracing example 7 Slow and narrow ECG Tracing example 8 Regular and wide ECG Tracing example 9 Osborn waves ECG Challenge The Cardiac Monitor is a dirty rotten scoundrel Connect with Tarlan Hedayati: Twitter: @HedayatiMD https://twitter.com/HedayatiMD Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding. Subscribe now at CurrentECG.com And Stay Current!

In this episode, Dave talks about augmented Vector Right (aVR). Many of us have been told, "Don't bother using lead aVR as part of your interpretation, you can't see anything in lead aVR, it won't give you any useful information." Nothing could be further from the truth. Also In This Episode Lead aVR, the forgotten lead Looking down through the heart, an intracavitary lead True trifurcation of the left main ST-Elevation in lead aVR and SD-Depression everywhere else Injury vectors ECG Tracing example 1 What about triple vessel disease? ECG Tracing example 2,3,4,5,6 Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding. Subscribe now at CurrentECG.com And Stay Current!

In this episode, Dave talks about COVID-19 and some additional information that clinicians and emergency care providers can use to help them identify and manage some of these patients. Also In This Episode ECG Tracing examples What does COVID-19 do to the heart? Not all viruses are the same Systemic inflammatory response Myocarditis: STEMI, HF, Shock Cytokine release ECG Tracing examples Risk factors Treatment Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding. Subscribe now at CurrentECG.com And Stay Current!

On this episode, Current ECG teams up with Master Your Medics to present a TCA Overdose case! Dave discusses the pathophysiology behind sodium channel blocking medications and how they affect cardiac depolarization at the cellular level. This is important because it affects how we interpret the ECG. Cardiac toxicity can develop quickly in TCA overdose, so get an ECG early in the clinical course if suspecting the diagnosis. Dave also discusses how sodium bicarbonate works to alter the patients ph level as well as competitively binding to sodium channel receptors helping to reverse the acidosis and TCA availability in the blood. Treatment options include: Oxygen Sodium bicarbonate for a QRS complex wider than 100ms. Assisted ventilations via BVM with potential for early intubation consideration which will help to blow off C02 0.9% Normal Saline What are some signs of TCA Overdose on the ECG? Sinus Tachycardia – most frequent dysrhythmia Widening of the QRS complex Prolongation of the PR or QT interval Right bundle branch block Non-specific intraventricular conduction delay (IVCD) Brugada pattern Wide-complex tachycardia (not ventricular tachycardia) Ventricular tachycardia / fibrillation How wide is too wide? A QRS duration >100ms is predictive of seizures and QRS >160ms is highly likely to experience a ventricular dysthymia. The ECG from our patient had a QRS of 144! . Check out Master Your Medics: https://podcasts.apple.com/ca/podcast/master-your-medics/id1235264636 . Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding. Subscribe now at CurrentECG.com And Stay Current! .